Ann Dermatol.  2019 Oct;31(5):525-529. 10.5021/ad.2019.31.5.525.

The Reappraisal of the Slide-Swing Skin Flap: A Versatile Technique for Surgical Defects

Affiliations
  • 1Department of Dermatology, Veterans Health Service Medical Center, Seoul, Korea.
  • 2Department of Dermatology, Gachon University Gil Medical Center, Incheon, Korea. parkhjmd@naver.com

Abstract

BACKGROUND
The slide-swing skin flap is a combination of transposition and adjacent skin sliding and can be used to close large, round defects with a flap that is smaller than the primary defect to produce aesthetically good results.
OBJECTIVE
To evaluate the efficacy and safety of the slide-swing skin flap for various surgical defects caused by skin tumor excisions.
METHODS
This retrospective case series, which includes 33 Asian patients between the ages of 25 and 86 years, describes the slide-swing skin flap after primary excision for malignant or premalignant skin conditions. The outcomes were assessed 12 weeks after surgery using the patient and observer scar assessment scale (POSAS).
RESULTS
Patients were 25 male and 8 female, and the causes of surgery were various malignant skin tumors including malignant melanoma, dermatofibrosarcoma protuberans, and malignant nodular hidradenoma. Tumors were on the lower limb in eleven patients, back in nine patients, chest in five patients, face in three patients, buttock in three patients and two patients had tumors in other locations. The mean defect size was 3.5×3.1±1.9×2.2 cm (range, 1.4×0.9~9.0×12.0 cm). The mean patient POSAS total score was 9.7±3.0 and mean patient overall opinion score was 1.8±0.7. The mean observer POSAS total score was 11.0±2.7 and mean observer overall opinion score was 1.9±0.5. All flaps survived and postoperative recoveries were uneventful.
CONCLUSION
The slide-swing skin flap is highly versatile and can be used to cover various surgical defects, irrespective of size and location, with excellent functional and cosmetic results.

Keyword

Skin neoplasms; Surgical flap

MeSH Terms

Acrospiroma
Asian Continental Ancestry Group
Buttocks
Cicatrix
Dermatofibrosarcoma
Female
Humans
Lower Extremity
Male
Melanoma
Retrospective Studies
Skin Neoplasms
Skin*
Surgical Flaps
Thorax

Figure

  • Fig. 1 Application of the slide-swing skin flap. (A) Preoperative design of the surgical excision with safety margins and two flaps (DBB' and AB'C). (B) After tumor excision, wide undermining and additional mobilization of the adjacent skin tissue (arrows) reduced surgical defect size. (C) Postoperative view.

  • Fig. 2 A 41-year-old female with malignant melanoma on her back. (A) The lesion was 3.5×4.5 cm and the resultant surgical defect was 9.0×12.0 cm. (B) Postoperative view at 2 weeks.

  • Fig. 3 An 82-year-old male with squamous cell carcinoma on his cheek. (A) The lesion was 3.0×2.6 cm. (B) Immediate postoperative view. A 70-year-old male with basal cell carcinoma on his right shoulder. (C) The lesion was 2.5×2.0 cm. (D) Postoperative view at 8 months.


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